New rule: Never go to a Cancer Doctor at the doctor’s request on Good Friday. Why? The news is unlikely to be ‘good news.’ During my April 4th clinical appointment, my Primary Care Physician recommended a friend whose a Cancer Orthopedic Surgeon. “His office will likely call to schedule you in a couple of weeks. He might be able to assist with pain management. I will forward his office your records this afternoon.” Several weeks later never happened; I received the call April 5th. 

“The doctor would like to schedule you for an appointment.”

“Ok,” I acknowledged while looking several weeks in advance. How about the week of April 24th or May 1st?”

“No,” the receptionist stated. “Doctor Lee needs to see you tomorrow?” 

“I can’t make it tomorrow.” 

“I have a 2:40 PM available on April 7th. Will that time work for you?”

Without thinking about the date, I accepted.

Historically speaking, Good Friday has been an awful date for me. I was diagnosed with MS early in my life on a Good Friday. Then, decades later, I was fired on Good Friday. Now, this appointment started percolating through my mind. It dawned on me later that the doctor needed to see me sooner, like right away. And in the medical world, it’s never a good sign when a doctor wants to see a patient immediately. 

Respecting all clinicians and their time, I arrived at 2:00 PM and completed the required paperwork. Dr. Lee arrived quickly. Figuring that I would get a cursory review and be sent home with a call me if anything changed, I rattled off my medical history as if I was in the third person.

Case Background: A 63-year-old man with osteoarthritis was infected by Coronavirus 19 in June 2022. Post-COVID-19 recovery, the man experiences off-and-on fatigue and bone ache throughout the next seven months and loses 30 pounds. After being referred to a specialized COVID clinic in September 2022, the patient attends his January 2023 appointment at the Medical University’s COVID-19 clinic. The COVID-19 clinic proceeds to order 13 different tests. Some of the critical test results indicated the following:

  1. Homocysteine: 12.7 umol/L (standard range is <11.4 umol/L)
  2. Vitamin D 25 Hydroxy: 27 ng/mL (standard rage is 30 – 100 ng/mL)
  3. Kappa light chain, free: 30.6 mg/L (standard range is 3.3 – 19.4 mg/L)
  4. Lambda light chain, free: 15.3 mg/L (standard range is 5.7 – 26.3 mg/L)
  5. Kappa/Lambda light chains free with ratio: 2.00 (standard range 0.26 – 1.65)
  6. Most of the Protein Electrophoresis, with reflex, serum was normal. However, the man’s Alpha-1 Globulin was 0.3 (within the standard range of 0.2 – 0.3 g/dL). Thus, although typical, the man’s Alpha-1 Globulin was at the highest point of ordinary.
  7. Protein: 8 g/dL (standard range 6.1 – 8.1 g/dL)
  8. ALBUMIN: 4.1 g/dL (standard range 3.8 – 4.8 g/dL)
  9. Alpha-2 Globuliin: 0.7 g/dL (standard range 0.5 – 0.9 g/dL)
  10. Beta-1 globulin 0.4 g/dL (standard range 0.4 – 0.6 g/dL)
  11. Beta 2 globulin: 0.3 g/dL (standard range 0.2 – 0.5 g/dL)
  12. Gamma globulin 1.0 g/dL (standard range 0.8 – 1.7 g/dL)

After poking and prodding for 35 minutes, Dr. Lee stated that the Kappa light chain test indicates you have cancer or early cancer. “It’s a ‘red flag.’ I am surprised no one got you here sooner.” 

“Couldn’t convince anyone that it was a major problem.”

Primary care physicians encounter many problems and require comprehensive knowledge to manage patients. They meet patients at the early undifferentiated stage of the disease, and most of the presentations are due to severe problems. However, a minority of patients’ presentations could be serious. Thus, one of the main tasks of a primary care doctor is to marginalize the risk of missing these severe illnesses. To achieve this, they can look for red flags and clinical indicators of possible extreme underlying conditions. All red flags, whether highly diagnostic or not, general or specific, warn us of the possibility of life-threatening disorders. Such red flags should be followed to determine their origin. 

Dr. Lee stated, “We must determine why the Kappa light chains and the associated ratio are high. We cannot let this go, and we can’t dismiss it.”

A clinician told me I probably had cancer in February, but after all these months, I found a doctor to fight for me. I am scheduled with hematology, a full body scan, and MRIs of the neck and back.

On this Good Friday, I have good news. It is this type of fight that God wants to do for you. People come to the community because they are suffering. They seek comfort and healing; they join to lift one another, provide one another strength, bathe the wounded in love, and believe in each other when they can no longer believe in themselves. A good doctor, a sound healer, a great leader, and an awesome God are those who cares for its most vulnerable. Find those who will fight for you.

Hint: Such leaders are not the leaders of today.